Zhou Sheng-Yue, Guo Mao-Dong, Ye Xiao-Hua
Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China.
World J Clin Cases. 2022 Jun 26;10(18):6314-6318. doi: 10.12998/wjcc.v10.i18.6314.
Acute lower gastrointestinal bleeding is common in clinical practice, and the colon is responsible for the majority of cases. However, appendiceal bleeding is an extremely rare cause. Appendiceal bleeding due to vascular diseases, such as angiodysplasia and Dieulafoy's lesion, may result in massive lower gastrointestinal bleeding. Appendectomy is a reliable and effective option for treatment.
A 32-year-old male presented to our hospital with hematochezia that had lasted for 6 h, with approximately 600-800 mL bloody stools and loss of consciousness for a few seconds. Persistent bleeding from the orifice of the appendix was observed by colonoscopy. Following the new diagnosis of appendiceal bleeding, the patient was treated by an emergency laparoscopic appendectomy. Finally, the patient was pathologically diagnosed with appendiceal Dieulafoy's lesion. The patient was uneventfully discharged, and follow-up 2 wk later showed no evidence of rebleeding.
Although appendiceal bleeding is a rare cause of acute lower gastrointestinal bleeding, clinicians should consider it during differential diagnosis.
急性下消化道出血在临床实践中很常见，大多数病例病因在结肠。然而，阑尾出血是一种极其罕见的病因。血管疾病如血管发育异常和Dieulafoy病变导致的阑尾出血，可能会引起大量下消化道出血。阑尾切除术是一种可靠且有效的治疗选择。
一名32岁男性因便血6小时入院，有大约600 - 800毫升血便，并有几秒钟的意识丧失。结肠镜检查发现阑尾开口持续出血。在新诊断为阑尾出血后，患者接受了急诊腹腔镜阑尾切除术。最终，患者经病理诊断为阑尾Dieulafoy病变。患者顺利出院，2周后随访未发现再出血迹象。
虽然阑尾出血是急性下消化道出血的罕见病因，但临床医生在鉴别诊断时应考虑到这一情况。
